title: Total marrow irradiation as part of autologous stem cell transplantation for Asian patients with multiple myeloma.
abstract: To compare the outcomes of melphalan 200 mg/m² (HDM200) and 8 Gy total marrow irradiation (TMI) delivered by helical tomotherapy plus melphalan 140 mg/m² (HDM140 + TMI 8 Gy) in newly diagnosed symptomatic multiple myeloma (MM) Asian patients. Between 2007 and 2010, nine consecutive myeloma patients who were scheduled to undergo autologous stem cell transplantation (ASCT) were studied. The patients received three cycles of vincristine-adriamycin-dexamethasone (VAD) regimen as induction chemotherapy, and if they had a partial response, peripheral blood stem cells were collected by dexamethasone-etoposide-cyclophosphamide-cisplatin (DECP). In arm A, six patients received the HDM200. In arm B, three patients received HDM140 + TMI 8 Gy. In arm B, the neutropenic duration was slightly longer than in arm A (P = 0.048). However, hematologic recovery (except for neutrophils), transfusion requirement, median duration of hospitalization, and the dose of G-CSF were similar in both arms. The median duration of overall survival and event-free survival was similar in the two arms (P = 0.387). As a conditioning regiment, HDM140 + TMI 8 Gy provide another chance for MM Asian patients who were not feasible for HDM200.
authors.affiliation: Division of Medical Oncology and Hematology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan ; Department of Nursing, Oriental Institute of Technology, New Taipei City 220, Taiwan ; Department of Biotechnology, School of Healthy Technology, Ming Chuan University, Taipei 111, Taiwan.
authors.forename: Shih-Chiang
authors.initials: SC
authors.lastname: Lin
authors.forename: Pei-Ying
authors.initials: PY
authors.lastname: Hsieh
authors.forename: Pei-Wei
authors.initials: PW
authors.lastname: Shueng
authors.forename: Hui-Ju
authors.initials: HJ
authors.lastname: Tien
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Wang
authors.forename: Chen-Hsi
authors.initials: CH
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D044466:Asian People; D001853:Bone Marrow / Q000528:radiation effects*; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000473:pathology / Q000628:therapy*; D011827:Radiation; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003561:Cytarabine; D014750:Vincristine; D003907:Dexamethasone; D008558:Melphalan